Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $7,413.10 / $12,022.64	Facility		$2,454.71	$7,413.10	$12,022.64
Aetna Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,737.80 / $6,165.95	Professional		$1,288.25	$1,737.80	$6,165.95
Ambetter Facility/Professional Professional Modifier Low / Median / High Price $1,047.13 / $1,202.26 / $1,698.24	Professional		$1,047.13	$1,202.26	$1,698.24
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $2,238.72 / $4,365.16 / $16,982.44	Facility		$2,238.72	$4,365.16	$16,982.44
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $1,288.25 / $1,659.59 / $2,951.21	Professional		$1,288.25	$1,659.59	$2,951.21
Aultcare Facility/Professional Professional Modifier Low / Median / High Price $1,380.38 / $1,380.38 / $1,380.38	Professional		$1,380.38	$1,380.38	$1,380.38
CareSource Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $1,584.89 / $3,311.31	Facility		$1,584.89	$1,584.89	$3,311.31
CareSource Facility/Professional Professional Modifier Low / Median / High Price $1,348.96 / $1,348.96 / $1,348.96	Professional		$1,348.96	$1,348.96	$1,348.96
Cigna Facility/Professional Facility Modifier Low / Median / High Price $2,454.71 / $2,691.53 / $21,379.62	Facility		$2,454.71	$2,691.53	$21,379.62
Cigna Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,778.28 / $3,162.28	Professional		$1,096.48	$1,778.28	$3,162.28
Medical Mutual of Ohio Facility/Professional Facility Modifier Low / Median / High Price $2,691.53 / $8,317.64 / $9,772.37	Facility		$2,691.53	$8,317.64	$9,772.37
Medical Mutual of Ohio Facility/Professional Professional Modifier Low / Median / High Price $1,096.48 / $1,778.28 / $2,951.21	Professional		$1,096.48	$1,778.28	$2,951.21
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $33.11	Professional		$32.36	$33.11	$33.11
SummaCare Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $1,445.44 / $6,456.54	Facility		$100.00	$1,445.44	$6,456.54
SummaCare Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,479.11 / $2,570.40	Professional		$1,122.02	$1,479.11	$2,570.40
United Facility/Professional Facility Modifier Low / Median / High Price $2,884.03 / $6,606.93 / $10,964.78	Facility		$2,884.03	$6,606.93	$10,964.78
United Facility/Professional Professional Modifier Low / Median / High Price $1,122.02 / $1,548.82 / $2,754.23	Professional		$1,122.02	$1,548.82	$2,754.23